The nurse cares for a client and receives a phone call from the laboratory department regarding a critical sodium level of 122 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. The nurse should take which initial action?
The nurse cares for a client and receives a phone call from the laboratory department regarding a critical sodium level of 122 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. The nurse should take which initial action?
A. Notify the primary healthcare provider (PHCP)
[21%]
B. Implement seizure precautions
[44%]
C. Read back the result for verification
[35%]
D. Recollect the laboratory specimen
[1%]
Statistics
Subject/Lesson
Subject
Fundamentals
Lesson
Basic Care & Comfort
Client Need
Test Plan
Reduction of Risk Potential
Related Topic
Lab Values
Item Type
Item Type
Application
Explanation
Choice C is correct. Before taking any action, the nurse should read back the result to ensure effective and safe communication. This step must not be skipped, as it guarantees accurate communication and prevents potential errors in patient identification and treatment. Critical results, such as a sodium level of 122 mEq/L (mmol/L), require immediate verification to ensure accuracy and patient safety.
Choice A is incorrect. While notifying the PHCP is important, it should be done after confirming the accuracy of the critical lab result. Reading back the result to the laboratory department is the immediate action required to ensure the correct information is received and documented.
Choice B is incorrect. Implementing seizure precautions may be necessary based on the critical sodium level, but the first step should be to confirm the accuracy of the result. Seizure precautions can be initiated after verifying the lab result.
Choice D is incorrect. Recollecting the specimen may be necessary in some cases, but it does not address the immediate need to verify the critical result. The priority is to confirm the accuracy of the existing result before taking further actions.
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4 Key Topics
Receiving/Transcribing Orders
15.1 Documentation, Consent & Information Systems
SBAR
15.2 Care Coordination & Communication
Additional Info
✓ When critical results are obtained, the nurse should clarify the results by reading back the results. This protects client safety by ensuring that the result is linked with accurate client identification.
✓ Communicate the critical result to the healthcare team, including the PHCP and other relevant specialists. Collaborate with them to determine the appropriate course of action, including potential medication adjustments or further diagnostic tests.
✓ Evaluate the client's overall clinical condition, including vital signs, neurological status, and any signs or symptoms related to the critical result. Monitor for signs of hyponatremia, such as confusion, seizures, or muscle weakness.
